Universität zu Köln

Slavin, Monica A., Chen, Yee-Chun, Cordonnier, Catherine, Cornely, Oliver A., Cuenca-Estrella, Manuel, Donnelly, J. Peter, Groll, Andreas H., Lortholary, Olivier, Marty, Francisco M., Nucci, Marcio ORCID: 0000-0003-4867-0014, Rex, John H., Rijnders, Bart J. A., Thompson, George R., Verweij, Paul E., White, P. Lewis, Hargreaves, Ruth, Harvey, Emma and Maertens, Johan A. (2022). When to change treatment of acute invasive aspergillosis: an expert viewpoint. J. Antimicrob. Chemother., 77 (1). S. 16 - 24. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with >= 2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Slavin, Monica A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, Yee-Chun UNSPECIFIED UNSPECIFIED UNSPECIFIED Cordonnier, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cuenca-Estrella, Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Donnelly, J. Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Groll, Andreas H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lortholary, Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED Marty, Francisco M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nucci, Marcio UNSPECIFIED orcid.org/0000-0003-4867-0014 UNSPECIFIED Rex, John H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rijnders, Bart J. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thompson, George R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Verweij, Paul E. UNSPECIFIED UNSPECIFIED UNSPECIFIED White, P. Lewis UNSPECIFIED UNSPECIFIED UNSPECIFIED Hargreaves, Ruth UNSPECIFIED UNSPECIFIED UNSPECIFIED Harvey, Emma UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, Johan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-606153
DOI:	10.1093/jac/dkab317
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	77
Number:	1
Page Range:	S. 16 - 24
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AZOLE RESISTANCE; MULTICENTER VALIDATION; ANTIFUNGAL THERAPY; FUNGAL DISEASES; ACUTE-LEUKEMIA; FUMIGATUS; VORICONAZOLE; INFECTION; ISAVUCONAZOLE; POSACONAZOLE Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60615